Impact of Cancer Treatment on Fertility of Testicles

Being diagnosed with cancer in your 20s or 30s is enough to think about without adding thinking about your fertility into the mix. Cancer and the treatments you might have for it can impact your fertility, but just how depends on your age, the sort of treatment you have and where in your body the cancer is. If you've got testicles, there are a few things to keep in mind about how your fertility might be impacted.

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Cancer treatments may affect your fertility by:

  • Stopping, or interfering with, the production of sperm in the testes.

  • Affecting the production of testosterone or others hormones involved in male fertility

  • Damaging nerves and blood vessels in the pelvic region, making it difficult to get an erection or ejaculate.

  • The need for surgical removal of the affected testis.

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Questions to ask your medical team

Your oncologist (cancer specialist) will be able to explain how your individual treatment will impact your fertility. If it's possible, they'll refer you to a specialist to discuss your options for fertility preservation. This usually needs to happen pretty quickly but you should still feel comfortable with any decisions you're making. Chat to your loved ones, people you trust and your medical team to make you're happy with your decision. You could ask your doctors:

  • Will my fertility be affected by my treatment?
  • Can I preserve sperm?
  • Are there any ways I can protect my fertility during treatment?
  • What type of contraception should I use during treatment?
Fertility after cancer treatment

It can be difficult to know the impact on your fertility immediately after cancer treatment, but your team or GP can do tests to find out what's what. There are four possible outcomes. You might have:

  1. Normal Fertility
    Normal sperm function and count. Many men undergo cancer treatment and are able to father children naturally with no change in their fertility.

  2. Temporary Infertility
    No sperm in the ejaculate. Sperm production may stop for a temporary amount of time. It may return immediately or many years after the cancer treatments end.

  3. Compromised Fertility
    Compromised sperm function and/or count. This can occur due to impaired sperm production, interference with hormone production or damage to the nerves and ducts that carry sperm out of the body. This can make natural conception hard and may require the assistance of fertility doctors.

  4. Permanent Sterility
    No ejaculated sperm. Some men will no longer produce sperm after treatment. There may be low levels of sperm in the testicles that may be used to try to have children with help from a doctor.

What about if I've already had my cancer treatment, or it's already underway?

If your treatment is already over, or it's already happening, it's important to chat to your team about any questions or concerns you have around your fertility. And remember, there are some really great organisations out there supporting people dealing with fertility issues, like the Fertility Network. Don't feel like you have to go it alone.

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